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General NPI Number Information
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NPI Number | 1023483559
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Entity Type | Organization
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Legal Business Name | SOUTH CHICAGO PARENTS AND FRIENDS, INC.
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 10241 S COMMERCIAL AVE
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City | CHICAGO
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State | IL
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Zip | 60617-5835
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Country | US
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Telephone | 773-734-2222
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Fax | 773-734-2850
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Provider Business Mailing Address
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Address Line | 10241 S COMMERCIAL AVE
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City | CHICAGO
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State | IL
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Zip | 60617-5835
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Country | US
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Telephone | 773-734-2222
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Fax | 773-734-2850
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. THOMAS M SCHELL
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Credential |
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Telephone | 773-734-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 199100087C
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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